Successful coil embolization of post-hepatectomy arterioportal fistula that reduced ascites and improved liver function

A 71-year-old man had previously undergone S7 + S8 dorsal segmentectomy and S5 partial hepatectomy for hepatocellular carcinomas. Six months later, he experienced abdominal distention. Abdominal computed tomography (CT) showed massive ascites and a significant hepatic arterioportal shunt. The ascite...

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Published inRadiology case reports Vol. 19; no. 6; pp. 2206 - 2210
Main Authors Okuhira, Ryuta, Sonomura, Tetsuo, Tanaka, Ryota, Inagaki, Riki, Ueda, Shota, Fukuda, Kodai, Higashino, Nobuyuki, Kamisako, Atsufumi, Sato, Hirotatsu, Ikoma, Akira, Minamiguchi, Hiroki
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Inc 01.06.2024
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Abstract A 71-year-old man had previously undergone S7 + S8 dorsal segmentectomy and S5 partial hepatectomy for hepatocellular carcinomas. Six months later, he experienced abdominal distention. Abdominal computed tomography (CT) showed massive ascites and a significant hepatic arterioportal shunt. The ascites was thought to be caused by portal hypertension due to a high-flow hepatic arterioportal fistula (HAPF). The fistula, located between the right hepatic artery A7 and the right portal vein, was embolized with microcoils under flow control using a balloon catheter. After embolization, the shunt blood flow disappeared and the hepatopetal venous flow was restored. His body weight and abdominal circumference decreased immediately, and his liver function on blood tests improved after the procedure. CT performed 11 days after embolization showed decreased ascites. A HAPF after hepatectomy is extremely rare. Balloon-assisted embolization using microcoils is a useful endovascular procedure for treating a high-flow HAPF.
AbstractList A 71-year-old man had previously undergone S7 + S8 dorsal segmentectomy and S5 partial hepatectomy for hepatocellular carcinomas. Six months later, he experienced abdominal distention. Abdominal computed tomography (CT) showed massive ascites and a significant hepatic arterioportal shunt. The ascites was thought to be caused by portal hypertension due to a high-flow hepatic arterioportal fistula (HAPF). The fistula, located between the right hepatic artery A7 and the right portal vein, was embolized with microcoils under flow control using a balloon catheter. After embolization, the shunt blood flow disappeared and the hepatopetal venous flow was restored. His body weight and abdominal circumference decreased immediately, and his liver function on blood tests improved after the procedure. CT performed 11 days after embolization showed decreased ascites. A HAPF after hepatectomy is extremely rare. Balloon-assisted embolization using microcoils is a useful endovascular procedure for treating a high-flow HAPF.
Author Ueda, Shota
Inagaki, Riki
Sato, Hirotatsu
Fukuda, Kodai
Ikoma, Akira
Tanaka, Ryota
Kamisako, Atsufumi
Higashino, Nobuyuki
Minamiguchi, Hiroki
Okuhira, Ryuta
Sonomura, Tetsuo
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Keywords Balloon catheter
Embolization
Hepatic arterioportal fistula
Microcoil
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2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.
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Snippet A 71-year-old man had previously undergone S7 + S8 dorsal segmentectomy and S5 partial hepatectomy for hepatocellular carcinomas. Six months later, he...
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StartPage 2206
SubjectTerms Balloon catheter
Case Report
Embolization
Hepatic arterioportal fistula
Microcoil
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Title Successful coil embolization of post-hepatectomy arterioportal fistula that reduced ascites and improved liver function
URI https://dx.doi.org/10.1016/j.radcr.2024.02.052
https://www.ncbi.nlm.nih.gov/pubmed/38515772
https://pubmed.ncbi.nlm.nih.gov/PMC10955095
https://doaj.org/article/e1e421f294d2493e8707958f97f51448
Volume 19
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